Why Tuesday?

Tuesday, June 29, 2010

What the hell is going on? I read an article yesterday in the Globe and Mail that suggests that sunscreen is dangerous for you health. Has the world gone completely bat-shit? Black is white? Left is right? Wrong is right? What the ....? Twenty five years ago I worshipped the sun as much as any eighties-child with a bottle of baby oil and a backyard. There we lay out on fold away cots made of multicoloured vinyl straps purchased from our local K-Mart. Coppertone coco butter scented oil poured as freely as oil from the Gulf as we waited for our pigments to turn and our lives to change.

Taking into account that I had also put lemon juice into my hair (in order to lighten it) and I was one part Margarita, one part Pina Colada and all parts... fabulous. Make no mistake, I truly looked and smelled ridiculous. I am aware of that now in retrospect. But I was 14 years old and a healthy sense of self esteem can be hard to come by in a teenager, so here to fore- I celebrate it.

It's no longer about simple protection from the sun. Now, products have to be hypo-allergenic, water resistant and fast-absorbing, infused with antioxidants, with high photo stability and specially engineered with patented ultraviolet absorbers to guard against a broad spectrum of harmful rays.

Meanwhile, environmental advocates are increasingly warning that a significant number of sunscreens also contain a host of risky ingredients that could potentially cause cancer or other serious health effects.

Part of the uncertainty stems from the growing availability of products that boast protection from both ultraviolet B and ultraviolet A rays. Traditionally, sunscreens have offered protection against UVB rays, which cause the skin to burn. The level of UVB protection in a particular sunscreen is marked by its sun protection factor, or SPF.

But there is mounting concern over the damaging effects of UVA rays, which scientists say penetrate deeper into the skin and can cause premature aging, as well as increase the risk of skin cancer.

Sunscreen protects against two common forms of skin cancer, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), and several sunscreen ingredients protect against tumor development in photocarcinogenicity tests in mice. However, there is some evidence, largely arising from correlational studies and in vitro experiments, that particular sunscreen ingredients (such as oxybenzone, benzophenone, octocrylene, or octyl methoxycinnamate) may be linked to increased risks of malignant melanoma, a rarer but more deadly form of skin cancer. It has also been linked to Vitamin D deficiency.

Two small studies have shown that Malignant melanoma has been found more frequently in sunscreen users compared to non-users in some studies. However a large scale met-analysis of 9067 patients from 11 case–control studies found no association between sunscreen use and development of malignant melanoma.

Furhter studies have suggested that sunscreens block the natural warnings and adaptations mediated by UVB, but allow damage from UVA to go unchecked. These claims were bullshit and essentially not supported in three separate metaanalysis in the Annals of Epidemiology.

Overall the only evidence to correlate a risk of melanoma and suncreen use is cicumstantial and there are a few rat models. That being said the mice they used in those studies were specifically engineered to develop cancer.

In 2008, a clinical study showed that the application of sunscreen prevents SCC, BCC and actinic keratosis. The study included 60 transplant patients who received immunosuppression, a group of persons with a particularly high risk to develop skin cancer. The patients were very compliant, using sunscreen 5.6 days per week on average. The control group was recruited retrospectively and consisted of 60 transplant patients equally matched for age, skin type and kind of transplant organ. The control group had been instructed to use sunscreen as well, but were not provided with cost-free sunscreen and showed very poor compliance.

After 24 months, the sunscreen group showed a 53% reduction of actinic keratosis, while the control group showed an increase of 38%. The difference in the development of SCC and BCC were also highly significant. Non-significant results included a slight decrease of herpes and warts and a slight increase in acne in the sunscreen group

My head is spinning. After reviewing it all I think it is yet another bullshit marketing ploy to get people to use "natural sunscreen" or confuse the public. Remember.... Grey is fabulous when it come to fall fashion and morality.... Grey areas are bullshit when it come to health promotion.

Here's my solutions.... Put on some CLOTHES damn it. YES! My reason for living saves the day again. I always wanted to know that my closet would protect me from cancer.... and here it is. Now... can I right it off as a health tax benefit?

And so my days of a teenage mixed drink are over. Coco butter oil and lemon be gone. I sit in the shade, wear a mother of a hat and the best pair of Don't bother me sunglasses I can buy.... bring out those fabulous Helmut Lang black dresses I have been eyeing since early May and let the healing begin.

Tuesday, June 22, 2010

I've been thinking a lot about heroes lately. Not the ones in the fabulous tights with the caps and mysterious identities but the average men and women who inspire us to be better... The everyday dudes that just happen upon a miracle and make it right.

This weekend I rode 250km to raise money for the RIDE TO CONQUER CANCER. There I was with 2235 men and women of all sizes and ages, of all fitness levels each with a motivation of some kind in order to just DO this. There was something in this weekend that was insiring them and motivating them for more. They were in search of a hero in their life- a means to be inspired and POOF! somewhere around kilometre 200 they each grew a superman magic cap and became something more than themselves.

It was inspiring to watch teams of people get together in the name of a loved one or a perfect stranger and make the world right for just a moment.

I met a group of riders from a group called "TEAM FIN". They were over 100 strong and had raised over a half a million dollars as a team for cancer research.

Finn was a little boy who loved life. Finn was diagnosed with a rare form of cancer called rhabdomyosarcoma at 20 months of age. Finn's treatment included multiple surgeries, chemotherapy, radiation and countless hospital stays. Three months after his last cancer treatment Finn was found to have a recurrence of his cancer that was ultimately incurable.

Since Finn's death in October 2008, his parents have been focused on keeping Finn's spirit strong. Finn laughed and played. He was a little boy with a big spirit. His father decided to establish TEAM FINN last year in the first RIDE TO CONQUER CANCER to honour his son's memory and to try and turn on a light in an otherwise blackened place in life.

And so TEAM FINN was born. In their pink jerseys with s sense of whimsy and fun they were a lesson in hope.

Make no mistake dear girlfriends, I am not naive enough to think that one day cancer with be off the face of this earth. But in those moments and along those miles with a "Finn" at my side, I thought of a time when we turn adversity into opportunity; when we teach life to dance and run and play; when we "bitch slap" sorrow and don't accept the status quo.

I have no medical research for you this week my cyber sisters... only a message with a bit of a medicinal slant...

If life really is all about the journey and the destination is unknown... this weekend I got a glimpse of a ride that was full of hope and laughter and everything that is good in humanity. And guess what? I liked it. I liked it alot.

Tuesday, June 15, 2010

Here's a dose of IRONY for my girlfriends.... I am too busy to write this blog about how busy we have become. I know the last thing we need is to hear a sister bitch but permit me if I may at least 500 words or less.... MAN AM I BUSY.

I know that the womens' movement was a revelation for all things female, but really? Did we have to burn our bras? I mean- who has time to go bra shopping anymore? Did we really have to fight for the right to vote? I mean, who even has time cast a vote these days? Can't I just hire someone to check the right box and be done with it?

I am clearly doing the work of a 1950's housewife AND I am working full time.

In fact I am writing this very "Busy Blog" on my lunch hour while a patient waits patiently in the waiting room. When dear girlfriends, did life get so crazy? When did we all have the notion that we had to be everything to everyone at all times?

My girlfriend's daughter is seven years old. She needs a special calendar to keep track of all her acitivities. Between lessons and sports and piano and play dates she is as busy as a salesgirl on Boxing Day. If this is how she is at seven how will she be in thirty plus years from now?

Yes, I am ranting. I am tired and burnt out. Crispy in fact and I lack the will to keep it all together for the sake of the cyber space. WHEN DID WE GET SO GOD DAMN FREAKIN' BUSY??!!!

What happened to the days where we jumped out of bed and just played on our bikes on bright summer days until the sun went down? Now I use my bike to get to work and all I can do to get out of bed in the morning is visualize the time when I will be able to crawl back into it.

If I knew then what I know now, I would have had so many less play dates and lesson plans. I would have breathed more and planned less.

A survey of Detroit adults published in 1983 in the Journal of Social Behaviour shows that employment, marriage, and parenthood are associated with good physical health for both women and men.

Employed married parents tend to have the best health profile, while people with none of these roles tend to have the worst profile. Of the three roles, employment has the strongest effect, and parenthood the weakest.

Multiple roles (the combination of job plus family responsibilities) have no special effects on health, either negative or positive. So, people with both job and family roles enjoy the health benefits of each role and incur no special health disadvantage for being so busy.

This is true for both women and men.

Three explanations are considered: First, health risks may actually be lower for socially active people than for nonactive ones. Second, involved people may have health attitudes which reduce their sensitivity to symptoms and their willingness to take curative health actions. Third, social selection may operate so that healthy people are able to acquire and keep roles more easily than unhealthy people.

In other words.... my busy life may make me bitchy right now... but it will be a longer life. According to the researchers in Detroit, I may be healthier for it and more proactive towards health because of it. Furthermore, the study shows I can probably handle it. So, I had best suck it up.

Wednesday, June 9, 2010

I recently got a job filming a documentary series (this is what reality television is now called) in northern British Columbia. The details of the show have been sealed away and for the sake of a nondisclosure agreement I will not reveal them here.

What I do want to delve into is the fact that the town I am working in is built around an oil plant. What, dear girlfriends, does living in the close proximity of a sea of fluorocarbons do to a girl (or boy or cow for that matter)?

A study published in Environment International in May, 2004 looked at the rate of Preterm delivery in Taiwanese women. The study found that women living near oil refineries in Taiwan were 20% more likely to have preterm deliveries than those living in other areas.

Given that I am not and never have been pregnant, this does not phase me in any way shape or form.

The International Journal of Epidemiology in 2002 published a study looking at the geographical differences in cancer in the Amazon basin based on proximity to oil refineries. Since 1972, oil companies have extracted more then 2 billion barrels of oil from the Ecuadorian Amazon.

The relative risk of cancers of the stomach, colon, kidney and skin were dramatically higher in those people living in close proximity to oil fields in Ecuador.

Again, the fact that I am nowhere near the Amazon is not lost on me.

A further Italian study in 2002 published in the Archives of Environmental Health looked at the cancer rates in Italy between 1980 and 1997. When controlling for all other risk factors (such as family history and smoking) there was an increase risk in cancers of the lung, colon, bladder and increased rates of leukemia in association with living proximity to industrial plants.

There is little data on the health risks of “visitors” to the refinery but I am assuming there has to be a bit of a “dose response”. In other words, when it comes to cancer risk…. Three days a week over the summer is a relatively low dose of exposure relative to living next to an oil refinery… It’s a nice place to visit but I would not want to live there.

Forgive me if I am on an “oil rampage” right now.

I can no longer watch what is happening in the Gulf of Mexico. My beloved is thoroughly obsessed with a broken oil well below the ocean that truly makes my heart ache. Last night I dreamt I was a manatee drowning in oil.

This may in part be due to the fact that I ate some funky cheese before bed and then listened to Jason rattle off the latest “BP STATS”. Every night before bed, he sits with his iPhone and details for me just how much oil has seeped into the Gulf that day and just how screwed we are.

Tonight I find myself in Northern BC only a few kilometers from the Alaska Highway and near one of the largest oil refineries in the land. Do my lungs now look like the Coast of Florida?

I know there is no comparison. I can only hope this planet will heal. I know I am a hypocrite. I participate in the benefits of the industrial revolution but hate to accept when the risks take hold. My BTU’s alone are an insult to humanity. I will try and do my little part. I will try and be as “green” as possible. I will carbon offset my ass off.

And every week that I fly up north to spend three days in the eye of the monster, I will breathe in and breathe out and hope for the best.

Tuesday, June 8, 2010

You will forgive my "one day more..." attitude that really should be reserved for Boxing Day Sales and Broadway musicals, however I do have an excellent excuse. It is my 13th wedding anniversary and worry not- I am not superstitious. We make our own luck in this world, dear girlfriends. That being said... we also make our own anniversary parties.

So give me one night off and I promise that tomorrow, as I have done for my husband for the last 13 years.... I will rock your world.

Tuesday, June 1, 2010

The ever expanding universe of fabulous has yet again thrown me another perfect gold plated “bone” so to speak with the opening of the newly renovated YMCA across the street from my home.

As many of my readers know, I am a big fan of Vancouver. I freakin love this city. I love the rain which makes my hair perfectly curly and my skin as soft as can be. I love the green all year round and the perfect summer days that make life truly worth living.

Most importantly, I love that being active is truly a priority in this town. Case and point is the new YMCA. Let’s be clear… this is not your mother’s YMCA. There is an airy spaciousness about it that is truly fabulous. There is a café that serves health conscious snacks and meals to go. There is a pool with a motorized movable floor and a whirlpool that is easily the size of my apartment.

There is an option for a “women’s plus” change room. This change room is en par with a spa. There is a private whirlpool and steam room and YES! Each shower has a stall (good-bye naked girl….)

The showers even have AVEDA products including shampoo and conditioner provided. Needless to say, I am truly in love with the fact that at 8 pm at night I can walk across the street, go for a swim, wash my hair with rosemary and mint shampoo and conditioner and then walk back across the street in my pajamas and go to bed. This is nirvana in the true sense of the word.

So last night I did just that. And as I was changing into my lovely p.j.’s after a perfect frolic in the water, I noticed a counter full of lovely jars of vanity products for the use of all the women in the “women plus” changing room. There they were- lovely rows of glass apothecary jars filled with razors and cotton balls and Q tips. And in front of them was a woman standing at the mirror and cleaning her ears.

Yes I know certain personal behaviours should be sacred and respected. We all have certain grooming habits that are unique and who is a sister to judge? I am sure the way I comb out my hair or apply product may look odd to some, but it is my ritualistic fingerprinted way and who would mock or judge my locker room habits? Well, unfortunately, I AM that judgemental sister. Besides, this woman was seriously going to town. I was quite concerned that I was going to have to do CPR on her ear drums at some point.

I must admit, I never understood the whole ear cleaning thing. I grew up in a strictly “non-ear cleaning” household. I seriously can not recall a time when we as a family did clean our ears. I remember a box of “Q-Tips” under the sink in the bathroom as a child, but I always thought they were for first aid; for applying some special medicine to “hard to reach” place.

Make no mistake, WE were a very clean household. IN fact my mother would wash the floors easily twice a day- to the point where I grew up thinking that it was perfectly acceptable to eat food if it had dropped on the floor. Why not? The floor had likely just been washed and was in fact clean enough to eat off of.

I was bathed daily as a infant and a child and the taught to take my own shower at about age 5. Hair, hands and face… all squeaky clean. Ears were never on the menu.

It turns out, my mother was a visionary.

A study published in Clinical Pediatrics in 1994 and conducted by the Dpeartment of Pediatrics at the Cleavland Clinic showed that cleaning your ears with cotton swabs is BULLSHIT.

They studied parents' and patients' approach to earwax (cerumen) removal, patients' level of cerumen occlusion, and the association between the use of cotton-tipped swabs ear wax/cerumen occlusion. Six hundred fifty-one consecutive patients from the general pediatric practice of the Cleveland Clinic aged 2 weeks to 20 years (57% males) answered a questionnaire with their parents' help. Of the 651, 401 (62%) had used cotton swabbed tips during the 2 months before the study.

Examiners unaware of the questionnaire results found that 46 (7%) of both right and left ear canals were at least 75% occluded by ear wax. Ear wax occlusion of at least 75% was associated with cotton swab tip use on the left side but not on the right side The study concluded that cotton-tipped swab use may be associated with cerumen accumulation.

Another study published in the British Medical Journal surveyed children’s ears for ear wax accumulation and asked them questions about cotton swab use. Of the children examined there was a significant prevalence of ear wax/cerumen plugs in children who had their ears cleaned with cotton tipped swabs as opposed to those who did not.

And so another week passes and I sigh a deep breath of relief that my years of neglect have lead to the cleanest ear canals money can buy. This morning in my clinic I even had a colleague look inside my ears to see what my “cerumen situation” was….

Apparently just like the childhood floors I grew up eating off of… my ears canals are spotless. And that, as they say, is music to my ears.

About Me

Dr. Ali Zentner received her undergraduate medical degree from McMaster University and completed her Internal Medicine Residency with an extra year of Cardiology training at the University of Calgary. Ali has been practicing Internal Medicine since 2001 as a specialist in Cardiac Risk Management and Obesity. Ali is the author of The Weight Loss Prescription, published by Penguin books in 2013. It is the ultimate guide for healthy living and one hell of a book (no bias here). Ali also wrote A Good Life, a work of fiction, published in 2003. The novel has been best described as “Sex in the City” meets “ER” and details one woman’s struggle to find meaning in a world not always under her control. Both books are available on amazon.com. A classic overachiever, Dr. Zentner has completed the Vancouver marathon, and half marathons in New York, Vancouver and Toronto. She is an avid swimmer, runner and cyclist training for her next triathlon and who exercises to keep fit and to justify her next fashion purchase. She lives in Vancouver with her husband who says nothing about the size of his wife’s shoe closet (if he knows what is good for him)…